Confidentiality Act

• In the 1970s, the U.S. Congress enacted confidentiality laws to protect people entering substance abuse and alcoholism treatment centers. The Confidentiality Of Alcohol And Drug Abuse Patient Records Regulation, also known as "42 CFR Part 2" or just "Part 2," mandates that substance abuse programs receiving federal assistance cannot disclose a patient's participation in the program---revealing that he has sought treatment for alcohol or drug abuse---nor any of his health information without that patient's consent. The regulation makes some exceptions that include medical emergencies, instances of child abuse, criminal activity on the center's premises, medical research, audits or evaluation activities.
  
  

Privacy Rule

• Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996 to standardize the privacy rights for patients throughout the health care system. In accordance with this legislation, the Department of Health and Human Services issued the Privacy Rule in 2000. Though the Privacy Rule is similar to Part 2, it allows substance abuse programs to release patient information for the purposes of "treatment, payment and health care operations"---allowances Part 2 does not make.
  
  

Non-Patient Identifying Disclosures

• Both Part 2 and the Privacy Rule allow substance abuse programs to release information about patients without their consent if it does not identify the patient as a substance abuser or alcoholic. Treatment centers that are part of a larger hospital may report to public health departments about serious diseases such as tuberculosis, as long as the center identifies itself by the larger hospital's name so that the patient isn't revealed to be receiving substance abuse treatment.
  
  

Minors

• The Privacy Rule permits mental health agencies to disclose information to the parents of a patient who is a minor, unless such disclosures conflict with other federal laws or state laws. Part 2 mandates that substance abuse centers must obtain written consent before releasing any information to a parent or legal guardian and such treatment programs are therefore bound to abide by the Part 2 law.
  
  

Subpoenas

• Part 2 prohibits substance abuse treatments centers from releasing a patient's information under a subpoena without consent, unless the subpoena is backed by a court order that meets Part 2 requirements. The Privacy Rule doesn't require a court order to release information under subpoena without consent, as long as there is evidence that the lawyer has made reasonable attempts to secure a qualified protective order or give the patient prior notice. The Substance Abuse and Mental Health Services Administration recommends that, in such cases, treatment centers defer to Part 2 rules regarding court orders.